Factors affecting the nature and extent of injuries:
(1) the size of the victim relative to the mouth opening of the cougar
(2) the extent to which the person or bystanders ward off the animal
Injuries and hazards include:
(1) lacerations
(2) puncture wounds from teeth
(3) blunt or crush trauma
(4) infection with Pasteurella multocida or other organisms in the cougar’s mouth
(5) rabies
(6) tetanus
(7) vascular injury, especially in the neck (vertebral artery, internal carotid artery)
(8) damage to the trachea
(9) phrenic nerve injury
(10) cervical spine injury
(11) post-traumatic stress disorder
Management includes:
(1) debridement of all bite wounds
(2) antibiotics to cover Pasteurella multocida and other oral flora of the cougar
(3) rabies prophylaxis
(4) tetanus prophylaxis
(5) careful examination of the head and neck, looking for subtle injuries
(6) psychological counseling
